HCFA Week 7 – Dispelling The Big Myth About Medicaid

By Kim Jones, Coordinator, Health Care for All WV  

       There are a lot of myths and misconceptions about Medicaid. The most common of these is that Medicaid is free health insurance for anyone who refuses to work and is just looking for a free ride. There are many political and ideological opinions that seem to support this myth. Here is a short list of who Medicaid covers.

       According to the Kaiser Family Foundation in 2021 “More than six in ten (61%) nonelderly adults with Medicaid were working full or part-time. The leading reasons for not working among remaining Medicaid adults were caregiving responsibilities, illness or disability, or school attendance. The remaining Medicaid adults reported that they are retired, unable to find work, or were not working for another reason.” 

       But by far, most Medicaid dollars go to support the health of our seniors and our children. Medicaid pays for low-income seniors who rely on nursing homes, while Medicare does not. In a state where 20% of the population is over 65 years old, and the poverty level is 17%, nursing home and home health care services are vital for older West Virginians. The annual cost of nursing home care is $60,000 a year. And we have to be realistic, the median household income of families in West Virginia is $50,884. How can we be expected to afford nursing home care in a state where generations of our people have had no options to choose from but to work low wage jobs? If a senior is on Medicaid, their pension and Social Security checks are applied to the cost of their nursing home care. So it still isn’t free. Medicaid also provides in-home health care services. These services help keep seniors safe and healthy in their homes at a much lower cost. 

       Medicaid covers nearly 50% of the births of West Virginia’s children. And it is also the health coverage plan for almost half (4 in 9) children in the state. West Virginians know that there is nothing more important than the health and wellbeing of our expectant parents, babies and children. Medicaid provides prenatal care, screenings for the mother and baby, prenatal vitamins, and ultrasounds. It covers the expenses of the birth of the child, to make sure the baby gets the best start in life despite a family’s income limitations. Medicaid in West Virginia also covers postpartum care for up to 12 months, to make sure the mother is in good health and not experiencing any physical health problems related to birth, postpartum depression or other issues. 

       The I/DD (Intellectual/Developmental Disabilities) Waiver is a Medicaid program that provides services for children and adults with disabilities. They cover therapies, respite care, vocational support. Or in the words of the WV DHHR “The West Virginia I/DD Waiver program reimburses for services to instruct, train, support, supervise and assist individuals to achieve their highest level of independence possible.”

       In a state ravaged by the drug epidemic, Medicaid covers medicinal treatments, mental health support, withdrawal treatment, and short term residential support to help our people suffering from addiction get back on their feet. 

       The reason this is all important is to put a face to the statistics. We all know someone who relies on these services. And we know that without the services their lives could be impacted in irreversible ways. 

       One good bill to address the looming funding shortfall is HB 5647. This bill will fund Medicaid with a provider tax on Managed Care Organizations. The bill has passed the House Finance Committee and will be up for a vote by the full House on Friday. Please click here and tell your delegate to vote to fully fund Medicaid!

       The WV Legislature has a number of ideas about how to cut spending on Medicaid, but the reality is healthcare in America is sickeningly expensive and getting more expensive. Our health is a commodity to be exploited for profit by entities posing as healthcare providers. Medicaid stands in the gap for millions of people who would otherwise suffer inhumane and cruel deprivation because of the insatiable greed of the American healthcare system.